ReviewCirculation2023
Unloading the Left Ventricle in Venoarterial ECMO: In Whom, When, and How?
Review in Circulation, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06645990 (Early Left Ventricular unLoading by Impella), which is not on this map. Cited by 95 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Early Left Ventricular unLoading by Impella (ECMELLA) or Intra-aortic Balloon Pump for Cardiogenic Shock in Patients on VA-ECMO
Who cites it
95 citing papers in PubMed, 6 syntheses or guidelines pooled it, 155 citations in OpenAlex.
- The effects of mechanical ventilation during v-a ecmo support: a systematic review.Critical care (London, England) · 2026Pooled it
- Concomitant Intra-Aortic Balloon Pump Throughout Extracorporeal Cardiopulmonary Resuscitation: A Meta-Analysis of Cohorts.Reviews in cardiovascular medicine · 2026Pooled it
- Meta-analysis of the predictive value of critical care echocardiography for weaning outcomes in patients with VA-ECMO-assisted cardiogenic shock.Frontiers in medicine · 2026Pooled it
- [Consensus paper on focused transesophageal echocardiography (fTEE) in clinical acute and emergency medicine : From the Commission for Clinical Cardiovascular Medicine of the DGK in cooperation with the DGINA, DGIIN and DGIM].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2025Guideline
- Impact of left ventricular unloading timing on clinical outcomes in venoarterial extracorporeal membrane oxygenation: an updated systematic review and meta-analysis.BMC cardiovascular disorders · 2025Pooled it
- Left ventricular decompression in paediatric veno-arterial extracorporeal life support: Reviewing the evidence.ESC heart failure · 2025Pooled it
- Venoarterial extracorporeal membrane oxygenation or standard care in patients with cardiogenic shock complicating acute myocardial infarction: the multicentre, randomised EURO SHOCK trial.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2023Trial
- Early Lower Pulmonary Arterial Diastolic Pressure Monitored With Pulmonary Arterial Catheters Is Associated With Improved Survival During VA ECMO for Patients With Acute Cardiogenic Shock: A Propensity-Matched Study.JACC. Heart failure · 2026Article
- Venous dimension of shock: Integrating arterial inflow and venous back-pressure in hemodynamic assessment.World journal of critical care medicine · 2026Review
- Primary Graft Dysfunction After Heart Transplantation for Chagas Disease With Refractory Electrical Storm.JACC. Case reports · 2026Article
- VA-ECMO Weaning in Low-Flow Low-Gradient Aortic Stenosis Post STEMI and ECPR.JACC. Case reports · 2026Article
- Lower AKI Risk and Higher Survival With Microaxial Flow Pump Support During Elective PCI: A Propensity Score-Matched Study.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2026Observational
- Left ventricular unloading during VA-ECMO for refractory cardiogenic shock: a target trial emulation multicenter analysis.Critical care (London, England) · 2026Article
- Successful destination therapy after stepwise mechanical circulatory support in a patient with cardiogenic shock following mechanical aortic valve replacement.Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs · 2026Article
- Partial carinal resection, reconstruction, and left pneumonectomy under median sternotomy combined with cardiopulmonary bypass: a case report.Journal of cardiothoracic surgery · 2026Article
- Extracorporeal Membrane Oxygenation in Refractory Cardiac Arrest: Current Evidence, Clinical Pathways and Future Directions.Life (Basel, Switzerland) · 2026Review
- Splanchnic ultrasound to guide unloading in VA-ECMO.The ultrasound journal · 2026Article
- Transseptal puncture in cardiovascular interventions: a clinical consensus statement of the European Heart Rhythm Association, the Heart Failure Association, the European Association of Percutaneous Cardiovascular Interventions, the European Association of Cardiovascular Imaging of the ESC, and the Association for European Paediatric and Congenital Cardiology.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026Article
- Renal replacement therapy in patients under extracorporeal membrane oxygenation: a narrative review.Critical care (London, England) · 2026Review
- Hemodynamic Effects of Adjunct Intra-Aortic Balloon Pumping During Veno-Arterial ECMO: A Pressure-Volume Loop Study.JACC. Case reports · 2026Article
35 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 7 institutions in 5 countries.
Funding
Abstract
Venoarterial extracorporeal membrane oxygenation provides cardiorespiratory support to patients in cardiogenic shock. This comes at the cost of increased left ventricle (LV) afterload that can be partly ascribed to retrograde aortic flow, causing LV distension, and leads to complications including cardiac thrombi, arrhythmias, and pulmonary edema. LV unloading can be achieved by using an additional circulatory support device to mitigate the adverse effects of mechanical overload that may increase the likelihood of myocardial recovery. Observational data suggest that these strategies may improve outcomes, but in whom, when, and how LV unloading should be employed is unclear; all techniques require balancing presumed benefits against known risks of device-related complications. This review summarizes the current evidence related to LV unloading with venoarterial extracorporeal membrane oxygenation.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.